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Xylazine use is spreading, often with fentanyl

The veterinary tranquilizer xylazine is increasingly being found in overdose deaths, especially in Philadelphia and nearby locales, according to a new report. 

Analysis of overdose death toxicology reports indicated that xylazine was present in only 0.36% of deaths between 2010 and 2015 across the US, but that it rose to 6.7% in 2020. It was found in 25.8% of deaths in Philadelphia, 19.3% in Maryland, and 10.2% in Connecticut. In over 98% of xylazine-associated deaths, fentanyl was also present. Interviews with people who inject drugs in Philadelphia indicate part of the draw of xylazine is its ability to lengthen the duration of effect of a dose of fentanyl. 

“[M]any jurisdictions do not routinely test for xylazine, and it is not comprehensively tracked nationally,” the authors noted. “Further efforts are needed to provide [people who inject drugs] with services that can help minimize additional risks associated with a shifting drug supply.”

Friedman J, Montero F, Bourgois P, et al. Xylazine spreads across the US: A growing component of the increasingly synthetic and polysubstance overdose crisis. Drug Alcohol Depend. 2022;233:109380.